Lithuanian Colorectal Cancer Implementation Guide, published by Lithuanian Medical Library. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7LT/ig-lt-colorectal/ and changes regularly. See the Directory of published versions

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: Sydney Classification for Colon Wall Injury

Active as of 2026-04-13

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{
  "resourceType" : "CodeSystem",
  "id" : "sydney-classification-cs",
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xml:lang=\"en\" lang=\"en\"><hr/><p><b>English</b></p><hr/><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem sydney-classification-cs</b></p><a name=\"sydney-classification-cs\"> </a><a name=\"hcsydney-classification-cs\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p></div><p>This case-sensitive code system <code>https://tx.hl7.lt/fhir/CodeSystem/sydney-classification</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">type-1<a name=\"sydney-classification-cs-type-1\"> </a></td><td>Sydney DMI Type I</td><td>Type I: Intact submucosa and muscularis propria with superficial mucosal injury only. No specific treatment is usually required.</td></tr><tr><td style=\"white-space:nowrap\">type-2<a name=\"sydney-classification-cs-type-2\"> </a></td><td>Sydney DMI Type II</td><td>Type II: Loss of clear distinction between submucosa and muscularis propria with focal loss of the submucosal plane. Endoscopic closure is usually suggested.</td></tr><tr><td style=\"white-space:nowrap\">type-3<a name=\"sydney-classification-cs-type-3\"> </a></td><td>Sydney DMI Type III</td><td>Type III: Visible target sign indicating injury to the muscularis propria. Endoscopic closure is required.</td></tr><tr><td style=\"white-space:nowrap\">type-4<a name=\"sydney-classification-cs-type-4\"> </a></td><td>Sydney DMI Type IV</td><td>Type IV: Clearly visible small-to-medium perforation, typically surrounded by a white cautery ring, without significant fecal contamination.</td></tr><tr><td style=\"white-space:nowrap\">type-5<a name=\"sydney-classification-cs-type-5\"> </a></td><td>Sydney DMI Type V</td><td>Type V: Large perforation with a visible hole and fecal contamination of the peritoneal cavity.</td></tr></table></div>"
  },
  "url" : "https://tx.hl7.lt/fhir/CodeSystem/sydney-classification",
  "version" : "0.0.1",
  "name" : "SydneyClassificationCS",
  "title" : "Sydney Classification for Colon Wall Injury",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-04-13T12:42:10+00:00",
  "publisher" : "Lithuanian Medical Library",
  "contact" : [
    {
      "name" : "Lithuanian Medical Library",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://medicinosnk.lt"
        },
        {
          "system" : "email",
          "value" : "info@medicinosnk.lt"
        }
      ]
    }
  ],
  "description" : "Sydney classification for deep mural injury (DMI) of the colon occurring during colonoscopy. The classification describes the severity of injury to the colon wall layers and helps guide appropriate management.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "LT"
        }
      ]
    }
  ],
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 5,
  "concept" : [
    {
      "code" : "type-1",
      "display" : "Sydney DMI Type I",
      "definition" : "Type I: Intact submucosa and muscularis propria with superficial mucosal injury only. No specific treatment is usually required."
    },
    {
      "code" : "type-2",
      "display" : "Sydney DMI Type II",
      "definition" : "Type II: Loss of clear distinction between submucosa and muscularis propria with focal loss of the submucosal plane. Endoscopic closure is usually suggested."
    },
    {
      "code" : "type-3",
      "display" : "Sydney DMI Type III",
      "definition" : "Type III: Visible target sign indicating injury to the muscularis propria. Endoscopic closure is required."
    },
    {
      "code" : "type-4",
      "display" : "Sydney DMI Type IV",
      "definition" : "Type IV: Clearly visible small-to-medium perforation, typically surrounded by a white cautery ring, without significant fecal contamination."
    },
    {
      "code" : "type-5",
      "display" : "Sydney DMI Type V",
      "definition" : "Type V: Large perforation with a visible hole and fecal contamination of the peritoneal cavity."
    }
  ]
}